TREATMENT OF HYPERHIDROSIS OF HANDS AND FEET BY IONTOPHORESIS :
The iontophoresis or ionophoresis constitute the first effective nonsurgical method usable in the treatment of perspiration (hyperhidrosis). It consists in exposing the hands and/or feet of the subject to a continuous electrical current who is conveyed by tap water.
Mode of action:
The epithelium of the glands eccrines comprises only one unicellular layer contrary to the skin consisted a suitable for paving epithelium  pluristratifié; Electric resistance y being thus less, the passage of the current will be made in a preferential way there, causing for certain authors, the formation of
epidermis clogs obliterating the sweat channels. For others the anatomy-pathological studies do not confirm this assumption. In practice, the very prolonged remissions sometimes obtained, (going up to 6 months), lead us to suppose that other still unknown mechanisms are in question. Currently although this idea was not shown, we think that the most relevant explanation is an effect of stabilization membrane of the cells of gland.
Material:
One needs a specific device for the treatment of the hyperhidrosis.
It includes:
A generator able to generate an adjustable and stable current in time.
Two vats of form adapted to the hands or the feet, in the content of which an electrode covered with a protection is. This one avoids the direct contact of the skin with metal. These vats electrodes are connected to the case by wires.
The intensity developed during the meetings is a function:
- of variable cutaneous resistance of a subject to another following the sex, the age, the profession, the percentage of moisture of
the teguments.
- of capacity of the patient to support the relatively unpleasant feeling of the current.
The device should not deliver an intensity higher than 30 milliamps, 20 mA being the intensity necessary and desirable for a good effectiveness of the treatment.
The apparatus must be independent of the main during the treatment.
Course of a session:
The patient lays out two ends to be treated in the vats electrodes (or four in the case of Iomax4)
Tap water is versed in these vats. The intensity is increased gradually up to 20 mA. A feeling of tingling, sometimes unpleasant, is perceived during the session.
After ten minutes, the intensity is gradually reduced up to zero. The current is then reversed, then the intensity very slowly brought back to 20 mA during same time.
Frequency of the sessions
Three sessions the first week.
Two sessions the second week.
Three sessions in the two following weeks.
In general the results appear as of the fourth
session.
Then a session of maintenance is to be envisaged in the fifteen days, three weeks, and gradually one arrives at a
session all the one at two months.
Countra-indications:
The most formal countra-indication relates to the cardiac pacemaker. Prudence forces to avoid this treatment at the pregnant woman (of which the hyperhidrosis improves besides often during the pregnancy).
For the women carrying a coil containing of metal, the opinions are divided. The theory does not highlight negative arguments, but until now no study in vivo makes it possible to slice this debate.
It is necessary to be careful with metal orthopedic implants, depending on it size and position (may divert the electric
current).
It should be known that this treatment is only symptomatic; it does not ensure the disappearance of the disorder, but only its suspension.
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